CGRN Hepatobiliary and Pancreatic Disorders 2

Question 1

A patient with hepatitis C cirrhosis undergoes surveillance ultrasound revealing a 2 cm hepatic lesion with arterial enhancement and washout on MRI. What is the most likely diagnosis?

Accepted Answer

Hepatocellular carcinoma (HCC)

Answer

Hepatic hemangioma

Answer

Focal nodular hyperplasia

Answer

Metastatic colorectal cancer

Question 2

Which medication is first-line therapy for primary sclerosing cholangitis (PSC) to slow bile duct fibrosis?

Accepted Answer

No proven disease-modifying therapy currently exists

Answer

Ursodeoxycholic acid (UDCA)

Answer

Cholestyramine

Answer

Prednisolone

Question 3

A cirrhotic patient develops sudden onset fever, abdominal pain, and ascitic fluid with PMN count >250 cells/mm³. What is the diagnosis?

Accepted Answer

Spontaneous bacterial peritonitis (SBP)

Answer

Secondary bacterial peritonitis

Answer

Hepatic encephalopathy

Answer

Portal hypertensive gastropathy

Question 4

Which scoring system is used to assess short-term mortality risk in acute variceal bleeding in cirrhotic patients?

Accepted Answer

MELD-Na Score

Answer

Glasgow-Blatchford Score

Answer

AIMS65 Score

Answer

Child-Pugh Score

Question 5

A patient with chronic pancreatitis presents with foul-smelling, oily stools and significant weight loss. What is the underlying mechanism?

Accepted Answer

Exocrine pancreatic insufficiency causing fat malabsorption

Answer

Bile acid malabsorption

Answer

Small intestinal bacterial overgrowth

Answer

Celiac disease triggered by chronic inflammation

Question 6

Which type of biliary stricture is most likely to develop after laparoscopic cholecystectomy?

Accepted Answer

Bismuth type I — low common bile duct stricture

Answer

Hilum stricture with hepatic duct involvement

Answer

Intrahepatic biliary stricture

Answer

Cystic duct remnant stricture

Question 7

A 45-year-old with acute liver failure has an INR of 3.8 and grade III encephalopathy. Which criterion must be met to qualify under King's College Criteria for emergency liver transplant listing?

Accepted Answer

PT > 100 seconds (INR > 6.5) OR any 3 of: age, etiology, bilirubin, time to encephalopathy

Answer

Serum bilirubin > 10 mg/dL

Answer

ALT > 5000 IU/L

Answer

Creatinine > 2.0 and sodium < 130